The Medical Training Review: Phase 1 diagnostic report (24 October 2025)

Summary

This diagnostic report sets out the current state of medical training and identifies 11 recommendations, including four key priorities: making training more flexible, building on excellence beyond formal routes, addressing damaging bottlenecks, and rebuilding inclusive team structures where doctors feel valued. While the report acknowledges risks and trade-offs in implementing major changes, it concludes that the gap between current practice and future needs is significant enough to justify action.

Content

Recommendations

1. We recommend that a reform of postgraduate medical education and training is undertaken as a matter of urgency.
2. Addressing bottlenecks at all points in training and development should be considered urgently. This will have to include consideration of the right ratio between new international graduate entrants to medicine in the UK and those who are already working and training in the NHS, taking into account the workforce need.
3. Training should become more flexible.
4. All doctors working in the NHS should be supported to progress and the differentiation between ‘training’ and ‘service’ roles should be made less rigid for doctors early in their careers. We recognise, however, that progression will not be at the same rate for all doctors.
5. The output from the review of rotational structures must be incorporated in the wider reforms.
6. Reform of medical training must consider the need to provide a medical workforce across the country for the whole population equitably. This means changes in medical school places and training places should take account of where medical need is growing and will grow in the future; this is seldom wealthy metropolitan areas. We recognise that there is a tension between this need and the geographical preferences stated by resident doctors.
7. A strategy to deliver educators who are supported and enabled to train the future medical workforce in a fit for purpose environment and with transparent funding should be a fundamental part of NHS reform. Training reform should aim to make the role of the educator less rather than more bureaucratic.
8. Resident doctors training in craft and procedure heavy specialties must have time to develop procedural skills, particularly early in their training. This includes requiring the independent sector to provide training if the NHS is commissioning and paying for the procedures it undertakes.
9. We should work with the other UK nations to support the GMC’s review of standards and outcomes and subsequent review by colleges of postgraduate training curricula, including considering changes from the 10 Year Health Plan. This will include maintaining generalist skills while specialising; and ensuring digital skills for all doctors, which are essential for future patient care.
10. The recruitment to medical training should be reviewed to ensure it supports future models of training delivery and training flexibility and is fair and equitable to all candidates, while aiming to recognise excellence in medical practice.
11. Clinical academic medicine is essential for the delivery of healthcare now and in the future, both in academic centres and across the NHS. This workforce should be developed to meet the current and future population health needs, particularly in primary care, community and public health settings.